[Correlation of adenomatous polyps and early colorectal cancer. Diagnostic and therapeutic implications]. / Relatia polip adenomatos--cancer colorectal precoce. Implicatii diagnostice si terapeutice.

AIM: To detect the patients with colorectal adenomatous polyps or those with adenocarcinoma areas with a view to prevent and to treat the malignant disease. MATERIAL AND METHOD: A prospective study including 309 patients hospitalized between 2000-2005 diagnosed with isolated adenomatous polyps after repeated colonoscopies. The research method was selective screening with identification of risk factors regarding the evolution of colorectal polyps in early cancer, using colonoscopy and histopathological examination. RESULTS: We identified 464 single or multiple isolated polyps of which 399 were adenomas, 59 hyperplastic polyps and 6 other types of lesions. Histologically we recorded 41 (13.27%) polyps with a low grade of dysplasia, 56 (18.12%) with severe dysplasia and 30 (9.7%) intramucosal adenocarcinoma with submucosal invasion. TREATMENT: Colonoscopic polypectomy was used for benign polyps and in situ carcinoma. In case of adenocarcinoma is probable the invasion of submucosal lymphatics being shown a colorectal resection as appropriate. We performed 279 colonoscopic polypectomies and 30 conventional resections. CONCLUSIONS: High grade of dysplasia, the number of polyps, ulceration, bleeding, intraepithelial areas of neoplastic transformation are predictive factors for early colorectal cancer. Depth of submucosal invasion of malignant transformed polyps are important pathological factors to predict lymphatic metastasis and to select the therapeutic procedure.

[A study of the incidence and the specific risk factors for surgical site nosocomial infections]. / Studiu asupra incidentei reale a infectiilor nosocomiale de sediu chirurgical si a factorilor de risc specific.

UNLABELLED: The aim of our study is to estimate the incidence of surgical site nosocomial infections in a general surgery department and also to present the importance of the risk factors associated with these infections using the latest diagnostic protocols. MATERIAL AND METHOD: a retrospective analysis of 3038 surgical procedures performed between 2000-2002. We identified all the patients with surgical site nosocomial infection (SSI) mentioned in the observation sheet using NNISS/HELICS protocols to appreciate the risk for surgical site nosocomial infections. The results were compared to those published in the literature. RESULTS: we selected 198 cases (6,55%) with surgical site nosocomial infections of 3024 surgical patients (we excluded 14 cases): 41.4% of them were superficial infections, 49% profound infections, 7.1% organ-space infections and 2.5% with mixed nosocomial infections. We analysed the incidence depending on the risk factors and the type of surgical procedure, the agents involved in the development of the postoperative nosocomial infections, the germs concerned and their antibiotics resistance. CONCLUSIONS: the rates of different NNISS values after surgical procedures with nosocomial infections are analysed relative to the rates published by HELICS study for Romania and other European countries and it shows larger rates than the european average, maybe because our country has not started yet the HELICS protocol for SSI.